Andreas Vesalius' 500th Anniversary: Initiation of the Superficial Facial System and Superficial Musculoaponeurotic System Concepts.

Because of their relevance for liposuction and rhytidectomies, respectively, the superficial fascial system (SFS) and superficial musculoaponeurotic system (SMAS) have been thoroughly studied over the past decennia. Although it is well known that the SMAS concept was introduced by Tessier in 1974, it remains unknown who first properly described the stratum membranosum of the SFS. In light of the 500th birthday of Andreas Vesalius (1515-1564), we searched his 1543 masterwork De Humani Corporis Fabrica Libri Septem and related work for references to these structures. We found ample reference to both structures as the membrana carnosa (or fleshy membrane) in his works and concluded that Vesalius recognized the extension, nature, and functions of the stratum membranosum of the SFS, as well as its more musculous differentiation as the SMAS in the head and neck area, and the dartos in the perineogenital area. In doing so, Vesalius recorded most details of the SFS and SMAS concepts avant la lettre.